Abstract 10985: Cardiopulmonary Assessment of COVID-19 Survivors Stratified by Acute Disease Severity and Post-Acute Symptoms

Introduction:Studies have demonstrated a reduction in peak oxygen consumption (VO2) post-acute COVID-19. We sought to determine the association between acute COVID-19 severity, post-acute symptoms and peak VO2after recovery.Methods:This study analyzed data from patients who recovered from COVID-19 and underwent cardiopulmonary exercise testing (CPET) as part of prospective studies in 5 centers across UK and Europe. Patients were asked to report current symptoms. Peak VO2, lung volumes, gas exchange, ventilatory efficiency, heart rate and O2pulse were measured in a standard symptom-limited incremental cycle ergometer CPET.Results:Among 417 patients examined 136±63 days after recovery from COVID-19, 164 (39%) were female. Mean age was 56.9±13.3 years. The spectrum of acute COVID-19 severity included critical (N=47; 11.3%), severe (180; 43.2%), moderate (75; 18.0%) and mild (115; 27.5%) illness. The most common post-acute symptom was dyspnea (200; 48%), followed by muscle pain (173; 41%). Mean peak respiratory exchange ratio was 1.13±0.1, and did not vary across acute disease severity or post-acute symptom status. There was no significant difference in peak VO2as % from predicted in mild to critical acute disease: 84.0±2.1%, 91.4±2.6%, 82.9±1.7% and 83.7±3.2%, respectively (p=0.06). Patients with dyspnea or muscle pain had each lower peak VO2as % from predicted, compared to patients free of the specific symptom (81.3±21.2% vs. 88.1±22.9%, p=0.002 and 78.6±19.1% vs. 88.2±22.0%, p<0.0001, respectively). Both dyspnea and muscle pain were each associated with significantly lower peak heart rate and peak O2pulse, as well as lower lung volumes and gas exchange capacity, compared to patients free of the specific symptom.Conclusions:Common post-acute COVID-19 symptoms, and not acute disease severity, are associated with lower peak VO2 in CPET. Parameters related to both cardiac and pulmonary function seem to play a role in this reduced physical performance.